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Introduction and importance COVID 19 infection is considered a potentially serious disease since it is responsible for important respiratory and cardiovascular complications with a high morbid-mortality. Case presentation We report the case of a 54-year-old diabetic patient with hypertension who was admitted for heart failure with a reduced LVEF of 23% triggered by a pulmonary embolism and an acute coronary syndrome in the context of COVID-19 infection. Clinical discussion Indeed, these complications may be secondary to a prothrombotic and hypercoagulable state as well as endothelial dysfunction caused by the vascular and systemic inflammation and cytokine storm induced by SARS-CoV-2. Although the clinical polymorphism of COVID 19 infection is recognized, the association of myocardial ischemia with pulmonary embolism is uncommon and of adverse prognosis. This justifies a rapid and adapted multidisciplinary management. Conclusion In the absence of contraindication, thromboprohylaxis should be initiated for all hospitalized patients with COVID-19 to minimize the risk of thromboembolic complications.

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